title: An unexpected Streptococcus pneumoniae strain.
abstract: This clinical driven report describes the unexpected detection of a multidrug resistant (MDR) Streptococcus pneumoniae strain. Italy is usually considered a country characterized by a low prevalence of MDR S. pneumoniae. We describe the occurrence of bacterial meningitis sustained by a MDR S. pneumoniae strain in Italy. The first-line treatment was started with ceftriaxone and dexamethasone, but after the identification of such a resistant strain a second-line regimen was needed. The new regimen was chosen on both susceptibility and pharmacokinetic criteria. Linezolid and levofloxacin were started and a dramatic improvement was observed. A more sensitive anamnesis revealed some elements known to be associated to a MDR S. pneumoniae occurrence (immunesuppression, former antibiotic therapy). So this case should pinpoint our attention on risk factors of MDR for a careful choice of antibiotic therapy in serious pneumococcal infections.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cenderello
authors.forename: Emanuele
authors.initials: E
authors.lastname: Pontali
authors.forename: Augusta
authors.initials: A
authors.lastname: Torresin
authors.forename: Giulia
authors.initials: G
authors.lastname: Milano
authors.forename: Filippo
authors.initials: F
authors.lastname: Ansaldi
authors.forename: Marcello
authors.initials: M
authors.lastname: Feasi
authors.forename: David
authors.initials: D
authors.lastname: Usiglio
authors.forename: Marco
authors.initials: M
authors.lastname: Mori
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Icardi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cassola
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000382:microbiology*; D013296:Streptococcus pneumoniae
chemical_list: D000900:Anti-Bacterial Agents
keywords: Immunecompromised host,; Linezolid treatment; S.pneumoniae MDR strain,; S.pneumoniae meningitis,